Time to review reflective practice?

Background: Reflective practice is an integral part of modern healthcare. If done well, it can significantly improve the individual skills of health care practitioners. However, we hypothesize that extrapolating individual reflective practice into broader organization applications undermines its fundamental nature and inhibits objective benchmarking within the health sector.

Employing interprofessional health teams to meet meso-level challenges: a short report.

This paper shares a report of how one New Zealand District Health Board (DHB) employed interprofessional health project teams to deliver system-wide health improvements and solve its immediate demand for additional hospital beds. CM Health provides health and disability services to approximately 512,000 people in its district. With increasing patient demand and no opportunity to increase capacity, CM Health needed a fast solution for its bed shortage.

De-Escalation Training to Medical-Surgical Nurses in the Acute Care Setting.

Violence is increasing on medical-surgical units as a "silent epidemic." This quality improvement project employs a small non-experimental, single-group, pre- and post-test design (N = 11) to determine the effectiveness of de-escalation training on medical-surgical nurses' confidence levels when dealing with agitated patients. Regardless of age, education, or years of experience, scores improved for each question on Thackrey's (1987) Confidence in Coping with Patient Aggression Instrument after implementing Ten Domains of De-escalation by Richmond et al.

Assessment of a Chronic Disease Self-Management Program to Increase Physical Activity of Adults With Severe Mental Illness.

Individuals with severe mental illness (SMI) experience excessive co-morbidities and early mortality. Self-management programs have the potential to increase physical activity levels of individuals with SMI and reduce the incidence of co-morbidities. The purpose of this quality improvement project was to assess a chronic disease self-management program (CDSMP) to increase physical activity of adults with SMI measured by daily steps tracked with a pedometer.

Leading Healthcare Change Across the Care Continuum: An Interview With Dr Kenneth Rempher.

Kenneth Rempher, PhD, MBA, CENP, RN, is the chief nursing officer for the University of Iowa (UI) Hospitals and Clinics. In his 20-year career, he has distinguished himself as a visionary healthcare leader. Colleagues describe Dr Rempher as a strong, transformational leader, guiding the UI enterprise through a time of uncertainty and change.

Application of CGEAN's Research Priorities: PhD, DNP Scholarship.

The Accountable Care Act of 2010 is stimulating rapid transformations of healthcare systems. The shift from a focus on providing healthcare in a closed system to improving the health of communities demands rapid innovation by nurse leaders. Nurse leaders prepared at the doctorate of nursing practice level and PhD-prepared nursing health services researchers are needed to develop and evaluate best practices as they emerge.

Nursing Administration Research Priorities: Findings From a Delphi Study.

Objective: The aim of this study is to determine the priorities for nursing administration research (NAR) in the United States.

Background: Previously known as the Council of Graduate Educators in Administrative Nursing, CGEAN provides an avenue for researchers and educators focused on NAR to partner, dialogue, obtain funding resources, and present their findings at a biennial International Nursing Administration Research Conference (INARC). In late 2013, with a goal of building consensus, CGEAN convened an INARC postconference to initiate the process of establishing critical NAR priorities for the future.

Establishing the Content Validity of an Early Extubation Protocol: A Quality Improvement Project for Improving Early Extubation of Coronary Artery Bypass Graft Patients.

Patients undergoing coronary artery bypass graft surgery will require intubation and the use of mechanical ventilation during and after surgery. It is well accepted that early extubation is associated with not only positive patient outcomes but also organizational outcomes as well. Patients who are not extubated early are at risk for complications associated with prolonged intubation.

Nursing Education: A Solution to Healthcare's Gordian Knot?

The Patient Protection and Affordable Care Act is dramatically increasing the complexity of the healthcare industry. In order to respond to the call for increased access and improved quality at lower costs, healthcare executives need new competencies to develop innovative solutions to complex problems. This column identifies and compares a few of the new nursing leadership competencies needed to current academic curricula.

Nursing administration research: an evolving science.

The nature and focus of nursing administrative research have evolved over time. Recently, the research agenda has primarily reflected the national health policy agenda. Although nursing research has traditionally been dominated by clinical interests, nursing administrative research has historically addressed the interface of reimbursement, quality, and care delivery systems.

An assessment of the alignment between graduate nursing leadership education and established standards.

The increasing complexity of healthcare systems is driving changes in the academic preparation of nurse leaders. The number of doctorate of nursing practice programs has increased. Leaders in the Council on Graduate Education for Administration in Nursing (CGEAN) were interested in learning how graduate nursing leadership programs have responded.

The Baltimore Buprenorphine Initiative: understanding the role of buprenorphine in addressing heroin addiction in an urban-based community.

Adequate drug treatment for substance users continues to be a challenge for most U.S. cities.

Crossing our quality chasm: continuing the case for graduate preparation of nurse managers and leaders.

The previous CGEAN Perspectives column compared the Baccalaureate Essentials document with American Nurses Credentialing Center (ANCC) and American Organization of Nurse Executives (AONE) certification examination content for nurse managers and concluded that the baccalaureate curriculum lacks the depth of content needed for today's frontline nurse leaders. This article continues the discussion by comparing the Master's Essentials document with ANCC and AONE nurse manager-level certification content to evaluate if a master's graduate education prepares nurses for the competencies of these management roles.

Crossing our quality chasm: heeding the case for graduate preparation of nurse managers and leaders.

As outlined by the Institute of Medicine's Future of Nursing, it is expected that nurses in direct care will be baccalaureate prepared. What then should be the expectation for educating nurse managers? This article compares the Baccalaureate Essentials with the American Nurses Credentialing Center and American Organization of Nurse Executives certification examination content for nurse managers to evaluate if baccalaureate education prepares these leaders for management roles in order to provide additional support for graduate education of nurse managers.

Data analytics: making the most of input with strategic output.

In this department, Drs Murphy, Wilson, and Newhouse highlight hot topics in nursing outcomes, research, and evidence-based practice relevant to the nurse administrator. The goal is to discuss the practical implications for nurse leaders in diverse healthcare settings. Content includes evidence-based projects and decision making, locating measurement tools for quality improvement and safety projects, using outcome measures to evaluate quality, practice implications of administrative research, and exemplars of projects that demonstrate innovative approaches to organizational problems.

Spirit-guided care: Christian nursing for the whole person.

Healthcare today is challenged to provide care that goes beyond the medical model of meeting physical needs. Despite a strong historical foundation in spiritual whole person care, nurses struggle with holistic caring. We propose that for the Christian nurse, holistic nursing can be described as Spirit-guided care--removing oneself as the moiatiating force and allowing Christ, in the furm of the Holy Spirit, to flow through and guide the nurse in care of patients and families.

Medication reconciliation across the continuum of care: a meaningful use mandate.

In this department, the authors highlight hot topics in nursing outcomes, research, and evidence-based practice relevant to the nurse administrator. The goal is to discuss the practical implications for nurse leaders in diverse healthcare settings. Content includes evidence-based projects and decision making, locating measurement tools for quality improvement and safety projects, using outcome measures to evaluate quality, practice implications of administrative research, and exemplars of projects that demonstrate innovative approaches to organizational problems.

Improving care transitions through meaningful use stage 2: continuity of care document.

In this department, Drs Murphy, Wilson, and Newhouse highlight hot topics in nursing outcomes, research, and evidence-based practice relevant to the nurse administrator. The goal is to discuss the practical implications for nurse leaders in diverse healthcare settings. Content includes evidence-based projects and decision making, locating measurement tools for quality improvement and safety projects, using outcome measures to evaluate quality, practice implications of administrative research, and exemplars of projects that demon strate innovative approaches to organizational problems.

Patients' access to their health information: a meaningful-use mandate.

This department highlights topics in nursing outcomes, research, and evidence-based practice relevant to nurse administrators. In this article, the authors describe patient access to personal health information as it relates to the meaningful-use requirement, technologies that have been used to enhance patient engagement, and the nursing leadership implications.

Students' experiences with military nurses as faculty.

The United States Army Nurse Corps (ANC) and the University of Maryland School of Nursing (UMDSON) formed a partnership to address the nursing faculty shortage. Six ANC officers served as full-time faculty at the UMDSON for a 2-year period. Given that the student experience is central to the context of learning, the purpose of this study was to describe the experience of the students who interacted with ANC officers.

Understanding the social and economic contexts surrounding women engaged in street-level prostitution.

Prostitution involves the exchange of sexual services for economic compensation. Due to the sexual promiscuity surrounding prostitution, women involved in prostitution constitute a high-risk group for contracting and transmitting STDs, including HIV. Prostitution is not only a public health concern, but also an economic one.